Clause 1 - Authorisation of activities for scheduled purposes
Human Tissue Bill
2:30 pm
Ms Rosie Winterton (Minister of State, Department of Health; Doncaster Central, Labour)
Before lunch, I was dealing with amendments Nos. 47 to 49. Unfortunately the hon. Member for Oxford, West and Abingdon (Dr. Harris) is not here yet, but I shall continue to address the points that he made.
I shall give a practical example of how we feel, in relation to part 2 of schedule 1, that there is a difference between taking tissue or cells from a living person and from one who is deceased. I shall do that by setting out what happens when consent is given to a post mortem. Included in that consent are activities intrinsic to the post mortem, which include tests, controls and information that will have been covered when consent to the post mortem was given. The code of practice will cover that. It is what is currently in the guidance that is issued to people informing them about what will happen in a post mortem.
However, with regard to a deceased person, keeping of tissue for subsequent quality control, clinical audit and so on would require consent. We will not allow tissue to be kept without the knowledge and agreement of the appropriate person. From living patients, we allow part 2 purposes without consent—beyond the consent of the clinical and diagnostic process—because audit quality control is bound up with the
diagnostic and clinical process. In the case of a post mortem, there is no reason not to discuss and agree such matters with the next of kin, and our current code of practice and model consent forms for post mortem illustrate how people would be taken through those points, among others.
I shall give a practical example of clinical audit and quality assurance in relation to a living person by referring to the example of cervical smear tests mentioned by the hon. Member for South Cambridgeshire (Mr. Lansley) this morning. Having taken a smear test, and carried out an initial quality assurance assessment of whether the test has been done properly, it is quite usual to keep the test for some time in case of future developments, or a further need because of what may have happened to a living patient. If there has been a development of the disease we may wish to go back and check that the quality assurance and clinical audit were done properly.
The idea of a post mortem is to find out the cause of death, and any check for quality assurance would be carried out at that time. The implications of keeping tissue, cells or organs from a post mortem for any length of time, would be strongly against the principles of the Bill. It could well aggravate the situation. An example of that would be the public health monitoring of living people, which is allowed without consent. It could be argued that such monitoring for CJD should and would be allowed if the amendments tabled by the hon. Member for Oxford, West and Abingdon were agreed to. That could mean whole brains being taken for future public health monitoring. For obvious reasons that is quite different from what can happen to a living person; it is not possible to perform such a removal of organs from a living person without pretty dire consequences.
Consent must be required for the purposes of part 2 of schedule 1 because the implications are different for someone who is deceased and someone who is alive.